Chapter 3: Community-Based Nursing Practice – Flashcards

ANS: B Public health nursing requires understanding the needs of a population. A public health nurse understands factors that influence the political processes used to affect public policy. The primary focus of community health nursing is the care of individuals, families, and groups in the community. By focusing on subpopulations, the community health nurse cares for the community as a whole and considers the individual or family as only one member of a group at risk.

ANS: D A specialist in public health has a graduate level education with a focus in public health science. Public health nursing requires preparation at the basic entry level and sometimes requires a baccalaureate degree in nursing. Not all hiring agencies require an advanced degree in community health nursing. However, nurses with a graduate degree in nursing who practicein community settings are considered community health nurse specialists, regardless of their public health experience

ANS: A The community health nurse understands the needs of a population or community through experience with individual families in working through their social and health care issues. Thecommunity-based nurse focuses on the needs of the individual or family. Community-based nursing centers function as the first level of contact between members of a community and thehealth care system. The community-based nurse learns to partner with patients and families sothat ultimately the patient and the family become involved in planning, decision making, implementation, and evaluation of health care approaches

ANS: C Community-based nursing involves acute and chronic care of individuals and families and enhances their capacity for self-care while promoting autonomy in decision making. Public health nursing focuses on the needs of a population. Community health nursing cares for the community as a whole and considers the individual or the family as only one member of a group at risk. Community-focused nursing understands the needs of a population or community.

ANS: B By focusing on subpopulations, the community health nurse cares for the community as a whole and considers the individual or the family as only one member of a group at risk. Community-based nursing, as opposed to community health nursing, focuses on the needs of the individual or family.

ANS: A By focusing on subpopulations, the community health nurse cares for the community as a whole and considers the individual or the family as only one member of a group at risk. Community health nursing is a nursing practice in the community, with the primary focus on the health care of individuals, families, and groups in a community. Subpopulations are often a clinical focus. The goal is to protect, promote, or maintain health, not to prevent illness.

ANS: B The ideal is to provide health care services close to where patients live. This lessens the cost of care as well as the stress associated with the financial burdens of care. The focus is on the needs of the individual or family. The nurse learns to partner with patients and families so they assume responsibility for their health care decisions.

ANS: B With the individual and the family as patients, the context of community-based nursing is family-centered care within the community. This focus requires a strong knowledge base in family theory, principles of communication, group dynamics, and cultural diversity. The nurse learns to partner with patients and families, so ultimately the patient and the family assume responsibility for their health care decisions.

ANS: A Community health nursing is a nursing practice with the primary focus on the health care of individuals, families, and groups in a community. The goal is to preserve, protect, promote, or maintain health. Not all hiring agencies require an advanced degree.

ANS: C Vulnerable populations are those patients who are more likely to develop health problems as aresult of excess risks or limits in access to health care services, or who are dependent on others for care. Pregnancy is not a cause of vulnerability, except in cases where the mother is an adolescent, is addicted to drugs, or is at high risk for other reasons. Frequently, the immigrant population practices nontraditional healing practices. Many of these healing practices are effective and complement traditional therapies

ANS: D Members of vulnerable groups frequently have many risks or a combination of risk factors that make them more sensitive to the negative effects of individual risk factors. Individual risk factors are not always overwhelming, depending on the patient's beliefs and values and sources of social support.

ANS: B The nurse should not judge the patient's/family's beliefs and values about health. The nurse needs to create a comfortable, non threatening environment and to learn as much as possible about the patient's culture and values that influence his or her health care practices. Tylenol may not be an acceptable alternative for this family. Criticizing the family's beliefs and practices will only create a barrier to care.

ANS: C Ask the man and woman to step out. When dealing with patients at risk for or who have suffered abuse, it is important to provide protection and to interview the patient at a time when he or she has privacy, and the individual suspected of being the abuser is not present. The boy may be less likely to be forthcoming with his attacker in the room. Confronting the man directly may lead to violence. The woman may also be a victim of abuse and may fear retribution if she discusses their problems with health care providers.

ANS: B As a counselor, the nurse is responsible for providing information, listening objectively, and being supportive, caring, and trustworthy. The nurse does not make decisions but rather helps the patient reach decisions that are best for him or her. To refuse to provide a referral or to delay referral would not be supportive of the patient's decision. Counselors usually suggest and rarely insist.

ANS: A The role of the community health nurse, when dealing with patients with Alzheimer's disease, is to maintain the best possible functioning, protection, and safety for the patient. The nurse should demonstrate to the primary family caregiver techniques for dressing, feeding, and toileting the patient while providing encouragement and emotional support to the caregiver. The nurse should protect the patient's rights and maintain family stability.

ANS: A Economic status is part of the community structure. Population would involve age and gender distribution, growth trends, density, education level, and ethnic or religious groups. The welfare system is part of the social system that also includes the education, government, communication and health systems.

ANS: B A community assessment should be done to determine the level of community violence at night in the patient's neighborhood. She claimed that she liked the program when it was at 9 AM. She did not mention finances as a reason for not going, and the program was within walking distance to her house. Noncompliance is a label given unfairly to patients. Most "noncompliance" is caused. The cause should be identified and dealt with, so the therapy will be successful.

ANS: A, B, C, E With the individual and family as the patients, the context of community-based nursing is family-centered care within the community. This focus requires a strong knowledge base in family theory, principles of communication, group dynamics, and cultural diversity. The nurseleans to partner with patients and families, not just with individuals.

ANS: A, B, C Community-based nursing centers function as the first level of contact between members of a community and the health care delivery system. Ideally, health care services are provided near where patients live. This approach helps to reduce the cost of health care for the patient and the stress associated with the financial burdens of care. In addition, these centers offer direct access to nurses and patient-centered health services and readily incorporate the patient and the patient's family or friends into a plan of care.

ANS: A, B, D, E For some immigrants, access to health care is limited because of language barriers and lack of benefits, resources, and transportation. Immigrant populations face multiple diverse health issues that cities, counties, and states need to address. These health care needs pose significant legal and policy issues. For some immigrants, access to health care is limited because of language barriers and lack of benefits, resources, and transportation. Low-risk mothers and babies usually are not considered vulnerable populations unless other factors are noted. Physical, emotional, and sexual abuse (such as rape), as well as neglect, is a major public health problem affecting older adults, women, and children. When a patient has a severe mental illness such as schizophrenia, multiple health and socioeconomic problems will need to be explored.